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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N° <br />573 <br />ZGe <br />Rec No <br />Comprehensive Plan Amendment Conditional Use PermiPAh') <br />Zoning District Amendment Variance 1 9 1991 <br />Text Amendment Subdivision r <br />Other \PG�bN Planned Unit DeveetoiVmeOFt LITTLE CANADA <br />Applicant // NO / , (/ zSO/,j <br />(Name) <br />Plan Review <br />,l/ e Co e✓ -B /'1e) 0 k c oa cL 77,2- 31"1-1 <br />(Address) (Phone) <br />Owner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />ri it /o .13 tri � 42e <br />aret5,4L�°,. <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signature of Applicant) <br />\ WHITE— Office CANARY — Customer PINK —File GOLD — Planner Page 21 <br />7 -/9- 2/ <br />(Date) <br />